APPLICANT / LIVESTOCK OWNER INFORMATION
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1 MINIMUM DISTANCE SEPARATION (MDS) QUESTIONNAIRE MDS I (to be completed for new development from existing livestock facilities) APPLICANT / LIVESTOCK OWNER INFORMATION Applicant: Name: Address: Postal Code: Phone: Fax: Livestock Owner: Name: Address: Postal Code: Phone: Fax: Property Description: Geographic Township: Municipality: County: Concession: Lot: Assessment Roll No.: 09 - _- _- _ Livestock Information: Type of Livestock (check all that apply): Type: Housing Capacity for this Livestock Beef: Cows (confinement) (includes calf up to 150 kg) Beef: Cows (yard/barn) Beef: Feeders (yard/barn) Chicken: Caged Layers Chicken: Breeder Layers Page 1 of 5
2 Chicken: Broilers Chicken: Pullets _ Dairy: Cows (includes calf up to 150 kg) - should the number you enter be multiplied by 1.5 to account for followers? Yes No Dairy: Heifers (yard/barn) Duck: Ducks Emu: Emus Fox: Adult Foxes (includes offspring to market size) Goat: Adult Goats (includes offspring until weened) Goat: Feeder Goats Horse: Horses (includes offspring until weened) Mink: Adult Mink (includes offspring to market size) Ostrich: Ostriches Rabbit: Adult Rabbits (includes offspring to market size) Sheep: Adult Sheep (includes offspring until weened) Sheep: Feeder Lambs Swine: Sows/Boars Swine: Feeder Hogs Swine: Weeners (4-30 kg) Chicken Pullets Turkey: Turkeys ( 10 kg) Turkey: Turkeys ( 5-10 kg) Turkey: Turkeys ( 5 kg) Turkey: Breeder Layers Turkey: Pullets Veal: White Veal Veal: Red Veal Other: (Please complete the following information) Name of animal or bird type: Housing Capacity for this Livestock Type: Page 2 of 5
3 Tillable hectares where livestock facility located: (do not include any land you may own/rent off this property) Which Number Best Describes the Manure Storage Structure (choose 1, 2, 3 or 4)?: 1. Roofed or covered storages for manure, runoff and milkhouse wash water. Includes any covered or roofed concrete, steel or earthen storages, in-barn solid manure packs and storages under fully slatted floors. 2. Open solid manure pile on concrete slab. Includes the runoff storages (concrete or earthen) used for capturing seepage liquids from solid manure storage or runoff liquids from yards. If yards are scraped into runoff storage, choose #3 when runoff storage is a concrete or steel tank when #4 runoff storage is earthen. Milkhouse washwater may be added to the runoff storage 3. Open concrete or steel tanks used for storing liquid manure, milkhouse washwater, or yard runoff where yard is scraped into storage. 4. Open earth-sided or earth sided storage with concrete floor to be used for storing liquid manure or yard runoff when yard is scraped into storage or millhouse washwater. Distance of Livestock Facility and/or Manure Storage from Property Lines and Road: Closest Distance from Livestock Facility to the new use: Metres Closest Distance from Manure Storage to the new use: Metres Size of Livestock Facilities: (as shown on attached sketch) Barn #1 Barn # 2 Barn #3 Barn #5 NOTES: If the consent is for a residential lot (vacant or residence existing) and the lot is no greater than 1 hectare in size, the measurement is taken as the shortest distance between the livestock facility and the lot line of the lot being created. Where larger lots may be proposed, a suitable location must be identified for a building envelope of approximately 1 hectare outside of the minimum separation distance. Livestock Facilities include barns where animals or poultry are housed, including beef feedlots and the associated manure storage. Tillable Hectares is land including pasture that can be worked or cultivated. The above information was supplied by: (print name) Signature Date: Verified by: Date: Page 3 of 5
4 Sample Sketch N Page 4 of 5
5 Sample Sketch N Page 5 of 5
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